Seasonal influence of tuberculosis diagnosis in Rwanda.

Autor: Uwamahoro D; Department of Anesthesia, Emergency Medicine and Critical Care, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda., Beeman A; Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA. alyssa_beeman@alumni.brown.edu., Sharma VK; Family Medicine Residency Program, Froedtert Hospital Menomonee Falls, Menomonee Falls, WI, USA., Henry MB; Columbia University-Vagelos College of Physicians and Surgeons, New York, NY, 10032, USA.; Department of Emergency Medicine, Maricopa Medical Center-Creighton University Arizona Health Education Alliance, Phoenix, AZ, USA., Garbern SC; Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA., Becker J; Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USA., Harfouche FD; Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA., Rogers AP; Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA., Kendric K; Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA., Guptill M; Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA.
Jazyk: angličtina
Zdroj: Tropical medicine and health [Trop Med Health] 2021 May 12; Vol. 49 (1), pp. 36. Date of Electronic Publication: 2021 May 12.
DOI: 10.1186/s41182-021-00328-w
Abstrakt: Background: Tuberculosis (TB) remains a major global health concern. Previous research reveals that TB may have a seasonal peak during the spring and summer seasons in temperate climates; however, few studies have been conducted in tropical climates. This study evaluates the influence of seasonality on laboratory-confirmed TB diagnosis in Rwanda, a tropical country with two rainy and two dry seasons.
Methods: A retrospective chart review was performed at the University Teaching Hospital-Kigali (CHUK). From January 2016 to December 2017, 2717 CHUK patients with TB laboratory data were included. Data abstracted included patient demographics, season, HIV status, and TB laboratory results (microscopy, GeneXpert, culture). Univariate and multivariable logistic regression (adjusted for age, gender, and HIV status) analyses were performed to assess the association between season and laboratory-confirmed TB diagnoses.
Results: Patients presenting during rainy season periods had a lower odds of laboratory-confirmed TB diagnosis compared to the dry season (aOR=0.78, 95% CI 0.63-0.97, p=0.026) when controlling for age group, gender, and HIV status. Males, adults, and people living with HIV were more likely to have laboratory-confirmed TB diagnosis. On average, more people were tested for TB during the rainy season per month compared to the dry season (120.3 vs. 103.3), although this difference was not statistically significant.
Conclusion: In Rwanda, laboratory-confirmed TB case detection shows a seasonal variation with patients having higher odds of TB diagnosis occurring in the dry season. Further research is required to further elucidate this relationship and to delineate the mechanism of season influence on TB diagnosis.
Databáze: MEDLINE
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